Abstract

Background

Cognitive behavior therapy (CBT) is regarded as an effective treatment for social
anxiety disorder (SAD) in Europe and North America. Individual CBT might be acceptable
and effective for patients with SAD even in non-Western cultures; therefore, we conducted
a feasibility study of individual CBT for SAD in Japanese clinical settings. We also
examined the baseline predictors of outcomes associated with receiving CBT.

Methods

This single-arm trial employed a 14-week individual CBT intervention. The primary
outcome was the self-rated Liebowitz Social Anxiety Scale, with secondary measurements
of other social anxiety and depressive severity. Assessments were conducted at baseline,
after a waiting period before CBT, during CBT, and after CBT.

Results

Of the 19 subjects screened, 15 were eligible for the study and completed the outcome
measures at all assessment points. Receiving CBT led to significant improvements in
primary and secondary SAD severity (ps < .001). The mean total score on the Liebowitz Social Anxiety Scale improved from
91.8 to 51.7 (before CBT to after CBT), and the within-group effect size at the end-point
assessment was large (Cohen’s d = 1.71). After CBT, 73% of participants were judged to be treatment responders, and
40% met the criteria for remission. We found no significant baseline predictors of
those outcomes.

Conclusion

Despite several limitations, our treatment—which comprises a 14-week, individual CBT
program—seems feasible and may achieve favorable treatment outcomes for SAD in Japanese
clinical settings. Further controlled trials are required in order to address the
limitations of this study.